AHIP PHIAS Practice Questions - Professional, Health Insurance Advanced Studies Exam

A key distinguishing feature of a Preferred Provider Organization (PPO) compared with an HMO is that a PPO:

Provides coverage for out-of-network providers at higher cost sharing Requires a PCP referral for all specialist visits Pays providers exclusively through capitation Excludes all out-of-network care except emergencies

Correct Answer:

Provides coverage for out-of-network providers at higher cost sharing

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